Provider

122 Pages·2017·2.3 MB·English

State Health Programs
Medi-Cal
Provider Directory
Directorio de Proveedores
Guide to choosing your doctor
Tulare, Volume 2, 2017
Hopper,
Health Net
Helping kids learn how
to stay healthy and ft.
Go team!
Table Of Contents
Introduction......................................................................................................................................................5
Clinics............................................................................................................................................................23
Delano.................................................................................................................................23
Dinuba................................................................................................................................ 23
Earlimart.............................................................................................................................23
Exeter..................................................................................................................................23
Farmersville........................................................................................................................ 24
Ivanhoe...............................................................................................................................24
Lindsay............................................................................................................................... 24
Orosi...................................................................................................................................24
Pixley..................................................................................................................................25
Porterville............................................................................................................................25
Springville...........................................................................................................................25
Terra Bella...........................................................................................................................25
Three Rivers........................................................................................................................25
Tipton..................................................................................................................................25
Traver................................................................................................................................. 25
Tulare..................................................................................................................................25
Visalia.................................................................................................................................26
Woodlake............................................................................................................................26
Primary Care Physicians.................................................................................................................................29
Delano.................................................................................................................................29
Dinuba................................................................................................................................ 32
Earlimart.............................................................................................................................33
Exeter..................................................................................................................................34
Farmersville........................................................................................................................ 34
Lindsay............................................................................................................................... 35
Orosi...................................................................................................................................36
Pixley..................................................................................................................................37
Porterville............................................................................................................................37
Springville...........................................................................................................................40
Terra Bella...........................................................................................................................40
Tipton..................................................................................................................................40
Tulare..................................................................................................................................41
Visalia.................................................................................................................................43
Woodlake............................................................................................................................46
Obstetrics and Gynecology Providers..............................................................................................................51
Delano.................................................................................................................................51
Dinuba................................................................................................................................ 52
Exeter..................................................................................................................................52
Pixley..................................................................................................................................53
Porterville............................................................................................................................53
Tulare..................................................................................................................................53
Visalia.................................................................................................................................54
Woodlake............................................................................................................................55
Specialist........................................................................................................................................................59
Delano.................................................................................................................................59
Dinuba................................................................................................................................ 64
Earlimart.............................................................................................................................64
Exeter..................................................................................................................................64
Lindsay............................................................................................................................... 70
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Orosi...................................................................................................................................70
Pixley..................................................................................................................................70
Porterville............................................................................................................................71
Tipton..................................................................................................................................74
Tulare..................................................................................................................................74
Visalia.................................................................................................................................79
Hospitals........................................................................................................................................................93
Delano.................................................................................................................................93
Porterville............................................................................................................................93
Tulare..................................................................................................................................93
Visalia.................................................................................................................................93
Skilled Nursing Facilities.................................................................................................................................97
Lindsay............................................................................................................................... 97
Porterville............................................................................................................................97
Tulare..................................................................................................................................97
Visalia.................................................................................................................................97
Facilities and Other Services.........................................................................................................................101
Delano...............................................................................................................................101
Dinuba...............................................................................................................................101
Exeter................................................................................................................................101
Porterville..........................................................................................................................101
Tulare................................................................................................................................101
Visalia...............................................................................................................................101
Pharmacies.................................................................................................................................................. 105
Dinuba...............................................................................................................................105
Earlimart...........................................................................................................................105
Exeter................................................................................................................................105
Farmersville.......................................................................................................................105
Lindsay..............................................................................................................................105
Orosi.................................................................................................................................105
Porterville..........................................................................................................................105
Three Rivers......................................................................................................................105
Tulare................................................................................................................................105
Visalia...............................................................................................................................106
Woodlake..........................................................................................................................107
Vision...........................................................................................................................................................111
Dinuba...............................................................................................................................111
Exeter................................................................................................................................111
Farmersville.......................................................................................................................111
Lindsay..............................................................................................................................111
Porterville..........................................................................................................................111
Tulare................................................................................................................................111
Visalia...............................................................................................................................111
Health Net Mental Health Providers...............................................................................................................115
Provider Index...............................................................................................................................................119
4 / www.healthnet.com Volume 2, 2017
Introdu
ction
Introduction
Choosing your primary care physician (PCP)
When you enroll with Health Net, you will select a primary care physician (PCP);
a PCP is a doctor who will be your personal doctor. Your PCP may be a family
practice, general practice, internal medicine, obstetrics and gynecology (OB/GYN),
or pediatrics (for your children) physician. You may want to have one doctor who will
see your whole family, or you may want to have one doctor for you and a different
doctor for your children.
Your PCP will be the doctor you will see when you Te Practice Locator Service is only available in
are sick; he or she will refer you to a specialist and English. If you do not speak English, please call
coordinate your health care whenever you need it. Health Net’s Member Services Department at
You must always see your PCP each time you need 1-800-675-6110. A representative will be happy to
medical treatment unless it is an emergency. You do contact the Practice Locator Service and provide you
not need to get a referral from your PCP to visit your with the information in your language.
eye doctor for a regular examination, for a family
All eligible Native Americans have the right to access
planning visit, for care during pregnancy, or to access
medical services through Indian Health Service
a nurse midwife.
facilities. You do not need a referral from your PCP.
If you are a female member, you may choose to see Te health plan will reimburse the facilities for
an OB/GYN for routine examinations and prenatal covered services.
care. You do not need a referral from your PCP, but
Some hospitals and other providers do not provide
you may ask him or her to recommend the name of
one or more of the following services that may be
an OB/GYN for you. Tere is also a listing of these
covered under this health plan and which members
providers in the section of your directory titled “OB/
might need: family planning; contraceptive services,
GYN Providers.” Te OB/GYN you choose must be a
including emergency contraception; sterilization,
Health Net provider and belong to the same medical
including tubal ligation at the time of labor and
group as your PCP.
delivery; infertility treatments; or abortion. Call
For assistance in locating a nurse midwife in your your doctor or clinic, or call Health Net’s Medi-Cal
area, please contact the American College of Nurse Member Services Department at 1-800-675-6110 to
Midwives’ electronic Practice Locator Service at ensure that you can obtain the health care services
1-888-MIDWIFE (643-9433). You will be asked to that you need.
enter your ZIP code, and you will be provided with
the name, address and telephone number of the nurse
midwife (or midwives) closest to your area.
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PCP Specialty Chart
Doctor specialty Who will he or she see?
Family practice Your whole family
General practice Your whole family
Internal medicine Adults only (age 18 and older)
OB/GYN Women only (age 18 and older)
Pediatrician Children only (age 18 and younger)
Te chart above will help you learn what each Health Net does not and cannot guarantee the
specialty (type of PCP) means, so you can choose the initial or continued availability of any particular
best doctor for you and your family. participating provider. Te current participation
status of any provider can be obtained by calling
Now that you have an idea about the type of doctor
Health Net’s Member Services Department at
you want as a PCP for yourself and your family, you
1-800-675-6110.
need to select who that doctor will be.
• Look for the city where you live.
• Pick a doctor for you and your family.
• Write the doctor ID (identifcation) number or the
name of the doctor(s) you choose for you and your
family on the Medi-Cal Health Plan Choice Form.
• Sign your name on the Medi-Cal Health Plan
Choice Form.
• Check to make sure you flled out the Medi-Cal
Health Plan Choice Form completely.
• Mail your completed Medi-Cal Health Plan Choice
Form in the self-addressed, stamped envelope
included with your packet.
6 / www.healthnet.com Volume 2, 2017
Member Identifcation Card
When you become a member of Health Net, you will receive a member identifcation
card like the one pictured below. You will need to show this card each time you see
your doctor, get your prescriptions (medicine), use the emergency room, or see your
eye doctor. Keep this card with you at all times.
Do not throw your Medi-Cal (BIC) card away and cannot reach him/her, please call our Member
You will need to use your Medi-Cal card to see your Services Department and a representative will
Medi-Cal dentist and to get some other services that connect you with a nurse who will be able to help you
are not covered by Health Net. and answer your questions.
Remember: If you have a life-threatening emergency,
24-hour Member Services Department call 911 for emergency help or go immediately to the
Health Net has a Member Services Department closest emergency room.
for you to call if you ever have any questions about
To talk to a Member Services representative, call
your health plan, want to change your doctor, or
1-800-675-6110. Tis is a free call for you to make,
have a complaint about your doctor or the plan. Te
and you can talk to someone 24 hours a day, every
Member Services Department is open 24 hours, every
day. Te Member Services Department phone
day, including weekends and holidays. A friendly
number is also on the back of your Health Net
representative is always available for you whenever
member identifcation card.
you need help.
Tank you for becoming a member of Health Net.
Member Services is your link to Health Net’s Nurse
We look forward to serving your health care needs.
Triage Department. If you try to call your doctor on
the weekend or afer ofce hours because you are sick,
You have selected the following medical group for your care. In order
to be covered by Health Net, all medical and hospital services must be
Group Name Issue Date: 06-15-02 rendered or authorized by:
MAINSTREAM Enrollment Date:
08-01-02 TEST MEDICAL GROUP
Member Name PCP NAME: NOEL JONES (SAMPLE)
GEORGIA SMITH (SAMPLE) DOB: 05-05-55 PCP ADDRESS: 888 SAMPLE STREET
Member ID # 12345678910 Group #: 0005900 YOUR CITY, CA 90000
PCP PHONE: [phone]
Health Net Member Services, 24 Hours
Member Inquiries and Provider Inquiries [phone] Efective Date with PCP: 08-01-02
GENERAL HOSPITAL
Pharmacy Claims processed by : First Health Bin #: 005260
Pharmacy Help Desk [phone] Ofce Copay $0 RX
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Accessibility Information
Below is information used in the provider directory to indicate accessibility at a
provider offce or building site. This information is not a promise that every doctor
will always have the access that you may need for a disability. You should call the
doctor’s offce to talk about your access needs for your disability.
Accessibility Requirements:
Basic: Facility represents all applicable accessibility Limited: Facility is missing one or more of the
requirements, excluding “T”. accessibility requirements, excluding “T”.
Indicator Defnition Criteria
Parking Parking spaces, including van-accessible space(s), are accessible. Pathways have curb
P
ramps between the parking lot, offce and at drop-off locations.
Exterior building Curb ramps and other ramps to the building are wide enough for a wheelchair or
EB scooter user. Handrails are provided on both sides of the ramp. Doors open wide
enough to let a wheelchair or scooter user enter and have handles that are easy to use.
Interior building Doors open wide enough to let a wheelchair or scooter user enter and have handles
that are easy to use. Interior ramps are wide enough and have handrails. Stairs, if
present, have handrails. If there is an elevator, it is available for public/patient use at all
IB
times the building is open. The elevator has easy to hear sounds and Braille buttons
within reach. The elevator has enough room for a wheelchair or scooter user to turn
around. If there is a platform lift, it can be used without help.
Restroom The restroom is accessible, and the doors are wide enough to accommodate a
wheelchair or scooter and are easy to open. The restroom has enough room for a
R wheelchair or scooter to turn around and close the door. There are grab bars which
allow easy transfer from wheelchair to toilet. The sink is easy to get to, and the faucets,
soap and toilet paper are easy to reach and use.
Patient diagnostic Patients are able to access and use testing and treatment areas, and equipment.
PD
and treatment use
PA Participant areas Members can get to and use all common areas and equipment with or without help.
Exam room The entrance to the exam room is accessible, with a clear path. The doors open wide
E enough to accommodate a wheelchair or scooter and are easy to open. The exam
room has enough room for a wheelchair or scooter to turn around.
Exam table/scale The exam table moves up and down, and the scale is accessible with handrails to assist
people with wheelchairs and scooters. The weight scale is able to accommodate a
T wheelchair. OR
Patients can get on or off medical equipment with or without help.
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Clinic Information
Below is information used in the provider directory to indicate different types of clinics.
Indicator Defnition
CC Community Clinic
COO County-Owned &/or Operated Clinic
FQHC Federally Qualifed Health Center
MXCL Mixed Specialty Clinic
RHC Rural Health Clinic
TIHC Tribal/Indian Health Clinic
DSHC Disproportionate Share Hospital Clinic
Volume 2, 2017 www.healthnet.com / 9
• D id you fnd something you think might be wrong • Y ou can ask for someone to help you talk with your
in any of our provider directories? Please let us doctor in your language. Tis is an interpreter.
know so we can fx it.
– To ask for an interpreter at no cost to you, please
– Call us at 1-800-675-6110 (TTY: 711). call Member Services at 1-800-675-6110 (TTY:
711). Please have your member ID number when
– Email us at